Pharmacists will be allowed to substitute hormone replacement therapy (HRT) products for alternatives if the original prescription is out of stock, as part of a host of new rules aimed at tackling the medicine shortage.

The additional power granted to pharmacists by the Department of Health and Social Care (DHSC) on Friday (20 May) comes alongside 10 new HRT Serious Shortage Protocols (SSP) involving five medicines, announced by PSNC last week.

The RPS is now urging the DHSC to make the power permanent, after initially calling for the move in part to save pharmacists’ time by allowing them to dispense substitute versions of medicines without having to contact the prescriber for permission.

The protocols will also allow pharmacists to supply a reduced quantity of the same HRT medicine or provide a reduced quantity of a specific alternative product.

Pharmacists have been told to ‘consider both the pharmacy’s stock levels of different HRT medicines and the patient’s circumstances before determining which of the SSPs is most appropriate.

‘Depending on the SSP used, the change in supply may require additional counselling to ensure that the patient is confident to take their medication,’ PSNC explained.

The new SSPs, which are for Lenzetto transdermal spray and Sandrena gel, can be implemented ‘with immediate effect’, and are in addition to the three introduced in April, PSNC added.

The ongoing SSPs apply to dispensing of dispensing for Oestrogel, Ovestin and Premique Low Dose.

The full list of SSPs and the details of what each protocol entails on the NHS BSA website.

In May, pharmacists in England were given powers to limit the amount of hormone HRT products to three months’ supply per person.

Calls to make protocol permanent

Professor Claire Anderson, president of the RPS, welcomed the news that more SSPs had been put in place for hormone replacement therapy products.

‘This short term measure will help women access supplies of HRT medicines which are difficult to get hold of,’ she said.

However, Ms Anderson called for the protocol to be made permanent to make the ‘whole process easier and quicker for both pharmacists and patients.

‘The bureaucracy involved in completing the SSP process for each patient is quite burdensome for pharmacists. We hope to see the shortage of HRT products resolved as soon as possible under the leadership of the new HRT Czar,’ she added.

Sajid Javid, the health and social care secretary said the Government was working to 'ensure HRT is available for everyone who needs it'.

'Meetings with suppliers are ongoing and we’re taking decisive action to manage HRT supply issues and reduce any delays - this includes issuing further SSPs so that women are able to access the medication they need,' he added.

Last year, the Government announced it would be launching a single annual prepayment for HRT.

The scheme, which some thought was meant to begin ‘within months’, was first announced in October 2021 and has the potential to save individuals up to £205 by enabling women to pay one charge for a 12-month supply of HRT.

However, its launch has already been delayed by a year. which pharmacy leaders have deemed ‘disappointing’. The Government now says this system will be implemented from April 2023.

The HRT shortages also come after prescription data, published last month, suggested HRT prescriptions had doubled over the last five years.